Otolaryngology
Head and Neck Surgery was one of the first areas in surgery where lasers found application and transformed clinical care. The carbon dioxide laser (CO2) remains the workhorse in the treatment of disorders of the upper aerodigestive tract in which non-contact, precise and hemostatic surgery is necessary. The role of the CO2 laser has expanded substantially in recent years and now is used to endoscopically remove advanced laryngeal and pharyngeal cancers, which previously required removal via a neck incision. Similarly, KTP: (Nd:YAG) and Ho:YAG lasers have been used to manage diseases in the nose, paranasal sinuses, larynx, and trachea. More recently, breathtaking advances in fiber laser technology and other non-conventional laser devices have lead to new applications in office-based laryngeal and upper airway surgery. Pulsed dye lasers are being more broadly adopted for treatment of a wide range of true vocal fold and laryngeal disorders. Lasers are used to treat ear disease and cranial base disorders as well. In otosclerosis, which is a fixation of the stapes footplate, “optical drilling” facilitates the precise removal of bone to improve hearing. Lasers are also used to reduce or eradicate vascular lesions and neoplasms in infants, children, and adults that obstruct the airway. As facial plastic surgeons, otolaryngologists also apply various laser wavelengths to resurface the face, reshape cartilage of the ear and nose, and manage vascular malformations. Currently, head and neck surgeons are at the forefront of using minimally invasive approaches such as imaged guided surgery, robotics and lasers to treat diseases within the head, neck, and upper airway.
